Tang Lap-Ming, Su Yu-Jang, Lai Yen-Chun
Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan ; Department of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
Springerplus. 2015 Jan 13;4(1):14. doi: 10.1186/s40064-014-0783-8. eCollection 2015.
Fournier's gangrene (FG) is an devastating disease that affects the perineum and genitourinary region, and is commonly a result of poly-microbial infection. This study is aimed to determine the correlation between micrology and prognosis of FG in the past five years.
This study was a retrospective cohort study that was designed to study the trends in micrology and prognosis of FG. From the PubMed database, articles published in the recent 5 years (from Jan1(st), 2009 to Dec 31(st), 2013) were reviewed. A total of 19 articles (each with n > 30 and with thorough data descriptions in the topic of Fournier's gangrene), were enrolled in this study. The consolidated data was further analyzed by commercial statistical software (SPSS for Windows).
The twenty-two studies have covered FG cases from year 1981 to 2011, with a mean duration of 9.2 years. The total number of cases is 4,365. Majority of the cases are male (84.1%). The mean age and mortality rate is 51.8 ± 5 years old and 11.1 ± 8.9%, respectivly. The most commonly found pathogen is poly-microbial organism (54%), followed by Escherichia coli (46.6%) and Streptococcus (36.8%). The major risk factors are diabetes (43.7%), Body mass index of > 30 (40.7%), and hypertension (38.1%). Mortality rate in older patient group (age > 51.8 years old) is significantly higher than those of the younger group (22% vs. 5.5%, p = 0.0001).
Older patients with genital or perineal pain should be examined for crepitus dermis. When a patient is diagnosed with FG, swift consultation with surgeons and administration of broad-spectrum antibiotics are required in order to save the patient's live.
福尼尔坏疽（FG）是一种侵袭会阴部和泌尿生殖区域的严重疾病，通常是多种微生物感染的结果。本研究旨在确定过去五年中FG的微生物学与预后之间的相关性。
本研究为回顾性队列研究，旨在研究FG的微生物学和预后趋势。回顾了PubMed数据库中最近5年（2009年1月1日至2013年12月31日）发表的文章。本研究共纳入19篇文章（每篇文章n>30，且在福尼尔坏疽主题中有详尽的数据描述）。合并数据通过商业统计软件（Windows版SPSS）进一步分析。
这22项研究涵盖了1981年至2011年的FG病例，平均病程为9.2年。病例总数为4365例。大多数病例为男性（84.1%）。平均年龄和死亡率分别为51.8±5岁和11.1±8.9%。最常见的病原体是多种微生物（54%），其次是大肠杆菌（46.6%）和链球菌（36.8%）。主要危险因素为糖尿病（43.7%）、体重指数>30（40.7%）和高血压（38.1%）。老年患者组（年龄>51.8岁）的死亡率显著高于年轻患者组（22%对5.5%，p=0.0001）。
对于有生殖器或会阴部疼痛的老年患者，应检查是否有皮下捻发音。当患者被诊断为FG时，需要迅速咨询外科医生并给予广谱抗生素治疗以挽救患者生命。
